贝前列素钠联合西地那非治疗肺动脉高压的临床观察  

Efficacy of Beraprost sodium combined with sildenafil in the treatment of pulmonary arterial hypertension

作　　者：杨京华[1,2] 朱晨曦[1,2] 王增智[1,2] 高伟[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所呼吸与危重疾病科,100029

出　　处：《心肺血管病杂志》2014年第6期816-819,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市科学技术委员会首都市民健康项目(Z131100004013012)

摘　　要：目的：评价在西地那非基础上加用贝前列素钠治疗第一大类肺动脉高压患者的随机对照研究,探讨贝前列素钠及西地那非单药及联合治疗的疗效及安全性.方法：连续收集符合标准的肺动脉高压患者30例,随机分成两组,分别给予西地那非、西地那非加贝前列素钠治疗,疗程12周.对入组患者进行基线评估,包括右心漂浮导管,超声心动图,WHO肺动脉高压功能分级（WHO-FC）、6分钟步行距离（6MWT）等检查,治疗随访12周后重复上述检查,评价两组的疗效和安全性.结果：两组肺动脉高压患者经治疗12周后运动耐力均改善,6MWT提高,WHO-FC改善,超声心动图肺动脉收缩压、右心导管肺动脉平均压及全肺循环阻力均降低,贝前列素钠加西地那非组疗效明显优于单独西地那非组,差异有统计学意义.药物不良反应：联合治疗组有30％患者早期出现轻度头晕,面色潮红、头痛及腹泻等,2～3w后可以耐受.西地那非组有26％的患者出现头痛、脸红消化不良及鼻出血,经1周后均耐受,不良反应发生率差异无统计学意义.结论：贝前列素钠与西地那非联合用药组较单独用药组能更有效的降低肺动脉压力,改善临床症状且安全.Objective： The purpose of this study was to assess the efficacy and safety of beraprost sodium combined with sildenafil in the treatment of pulmonary arterial hypertension（ Group 1 ）. Methods： 30 adult patients with pulmonary arterial hypertension were randomly divided into two groups ： combination therapy group 15 cases（oral sildenafil and beraprost ） , sildenafil therapy group 15 cases （oral sildenafil alone） , Patients in every group received relevant medicine for 12 weeks, respectively. All patients hemodynamic parameters, WHO- functional class, 6-rain walking distance were record before and 12weeks later after treat ment. Results： During a follow-up of 12 weeks, combination therapy group had significantly improved exercise capacity, 6-minute walk test and WHO- function class, pulmonary artery pressure and pulmonary vascular resistance decreased obviously than that of oral sildenafil alone group P 〈 0. 05 ）. beraprost-related adverse events were headache, hot flushes, diarrhoea, two groups had no significant adverse effects. Conclusion： These data indicate that beraprost sodium combined with sildenafil represents a safe and effective therapeutic option for patients with PAH, at least in short-term, The long-term outcomes of such combination therapy need further study.

关 键 词：肺动脉高压 贝前列素钠 西地那非 

分 类 号：R56[医药卫生—呼吸系统]